脑偏侧化在肢体短缺患儿中的表现。
Brain lateralization in children with upper-limb reduction deficiency.
机构信息
Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE, 68182, USA.
Department of Special Education and Communication Disorders (SECD), University of Nebraska-Lincoln, Lincoln, NE, 68182, USA.
出版信息
J Neuroeng Rehabil. 2021 Feb 3;18(1):24. doi: 10.1186/s12984-020-00803-1.
BACKGROUND
The purpose of the current study was to determine the influence of upper-limb prostheses on brain activity and gross dexterity in children with congenital unilateral upper-limb reduction deficiencies (ULD) compared to typically developing children (TD).
METHODS
Five children with ULD (3 boys, 2 girls, 8.76 ± 3.37 years of age) and five age- and sex-matched TD children (3 boys, 2 girls, 8.96 ± 3.23 years of age) performed a gross manual dexterity task (Box and Block Test) while measuring brain activity (functional near-infrared spectroscopy; fNIRS).
RESULTS
There were no significant differences (p = 0.948) in gross dexterity performance between the ULD group with prosthesis (7.23 ± 3.37 blocks per minute) and TD group with the prosthetic simulator (7.63 ± 5.61 blocks per minute). However, there was a significant (p = 0.001) difference in Laterality Index (LI) between the ULD group with prosthesis (LI = - 0.2888 ± 0.0205) and TD group with simulator (LI = 0.0504 ± 0.0296) showing in a significant ipsilateral control for the ULD group. Thus, the major finding of the present investigation was that children with ULD, unlike the control group, showed significant activation in the ipsilateral motor cortex on the non-preferred side using a prosthesis during a gross manual dexterity task.
CONCLUSIONS
This ipsilateral response may be a compensation strategy in which the existing cortical representations of the non-affected (preferred) side are been used by the affected (non-preferred) side to operate the prosthesis. This study is the first to report altered lateralization in children with ULD while using a prosthesis. Trial registration The clinical trial (ClinicalTrial.gov ID: NCT04110730 and unique protocol ID: IRB # 614-16-FB) was registered on October 1, 2019 ( https://clinicaltrials.gov/ct2/show/NCT04110730 ) and posted on October 1, 2019. The study start date was January 10, 2020. The first participant was enrolled on January 14, 2020, and the trial is scheduled to be completed by August 23, 2023. The trial was updated January 18, 2020 and is currently recruiting.
背景
本研究的目的是确定上肢假肢对先天性单侧上肢减少缺陷（ULD）儿童与正常发育儿童（TD）大脑活动和总体灵巧性的影响。
方法
5 名 ULD 儿童（3 名男孩，2 名女孩，8.76±3.37 岁）和 5 名年龄和性别匹配的 TD 儿童（3 名男孩，2 名女孩，8.96±3.23 岁）在进行总体手动灵巧性任务（Box and Block Test）的同时测量大脑活动（功能近红外光谱；fNIRS）。
结果
使用假肢的 ULD 组（每分钟 7.23±3.37 块）和使用假肢模拟器的 TD 组（每分钟 7.63±5.61 块）之间在总体灵巧性表现方面没有显著差异（p=0.948）。然而，在使用假肢的 ULD 组的侧性指数（LI）（LI=-0.2888±0.0205）和使用模拟器的 TD 组的 LI（LI=0.0504±0.0296）之间存在显著差异（p=0.001），表明 ULD 组的对侧控制存在显著差异。因此，本研究的主要发现是，与对照组不同，患有 ULD 的儿童在使用假肢进行总体手动灵巧性任务时，在非优势侧的对侧运动皮层显示出显著的激活。
结论
这种对侧反应可能是一种代偿策略，即利用非受损（优势）侧的现有皮质代表来操作假肢。本研究首次报告了使用假肢的 ULD 儿童的侧化改变。
试验注册
该临床试验（临床试验.gov 注册号：NCT04110730 和独特方案 ID：IRB#614-16-FB）于 2019 年 10 月 1 日（https://clinicaltrials.gov/ct2/show/NCT04110730）注册，并于 2019 年 10 月 1 日发布。研究开始日期为 2020 年 1 月 10 日。第一名参与者于 2020 年 1 月 14 日入组，试验计划于 2023 年 8 月 23 日完成。试验于 2020 年 1 月 18 日更新，目前正在招募参与者。
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